de Godoy Luciana Balester Mello, Luz Gabriela Pontes, Palombini Luciana Oliveira, E Silva Luciana Oliveira, Hoshino Wilson, Guimarães Thaís Moura, Tufik Sergio, Bittencourt Lia, Togeiro Sonia Maria
Universidade Federal de São Paulo, Departamento de Psicobiologia, São Paulo, Brasil.
PLoS One. 2016 May 26;11(5):e0156244. doi: 10.1371/journal.pone.0156244. eCollection 2016.
To compare sleep quality and sustained attention of patients with Upper Airway Resistance Syndrome (UARS), mild Obstructive Sleep Apnea (OSA) and normal individuals.
UARS criteria were presence of excessive daytime sleepiness (Epworth Sleepiness Scale-ESS-≥ 10) and/or fatigue (Modified Fatigue Impact Scale-MFIS-≥ 38) associated to Apnea/hypopnea index (AHI) ≤ 5 and Respiratory Disturbance Index (RDI) > 5 events/hour of sleep or more than 30% of total sleep time with flow limitation. Mild OSA was considered if the presence of excessive daytime sleepiness (ESS ≥ 10) and/or fatigue (MFIS ≥ 38) associated to AHI ≥ 5 and ≤ 15 events/hour. "Control group" criteria were AHI < 5 events/hour and RDI ≤ 5 events/hour and ESS ≤ 9, without any sleep, clinical, neurological or psychiatric disorder. 115 individuals (34 UARS and 47 mild OSA patients and 34 individuals in "control group"), adjusted for age, gender, body mass index (BMI) and schooling years, performed sleep questionnaires and sustained attention evaluation. Psychomotor Vigilance Task (PVT) was performed five times (each two hours) from 8 a.m. to 4 p.m.
UARS patients had worse sleep quality (Functional Outcomes of Sleep Questionnaire-FOSQ-and Pittsburgh Sleep Quality Index-PSQI: p < 0.05) and more fatigue than mild OSA patients (p = 0.003) and scored significantly higher in both Beck inventories than "control group" (p < 0.02). UARS patients had more lapses early in the morning (in time 1) compared to the results in the afternoon (time 5) than mild OSA (p = 0.02). Mild OSA patients had more lapses in times 2 than in time 5 compared to "control group" (p = 0.04).
UARS patients have a worse sleep quality, more fatigue and a worse early morning sustained attention compared to mild OSA. These last had a worse sustained attention than controls.
比较上气道阻力综合征(UARS)患者、轻度阻塞性睡眠呼吸暂停(OSA)患者和正常个体的睡眠质量及持续注意力。
UARS的标准为存在日间过度嗜睡(爱泼沃斯嗜睡量表-ESS-≥10)和/或疲劳(改良疲劳影响量表-MFIS-≥38),且呼吸暂停/低通气指数(AHI)≤5,呼吸紊乱指数(RDI)>5次/小时睡眠或超过总睡眠时间的30%伴有气流受限。若存在日间过度嗜睡(ESS≥10)和/或疲劳(MFIS≥38),且AHI≥5且≤15次/小时,则考虑为轻度OSA。“对照组”标准为AHI<5次/小时,RDI≤5次/小时,ESS≤9,且无任何睡眠、临床、神经或精神疾病。115名个体(34名UARS患者、47名轻度OSA患者和34名“对照组”个体),根据年龄、性别、体重指数(BMI)和受教育年限进行调整后,进行睡眠问卷和持续注意力评估。从上午8点到下午4点,每两小时进行一次精神运动警觉任务(PVT),共进行5次。
UARS患者的睡眠质量较差(睡眠功能结果问卷-FOSQ-和匹兹堡睡眠质量指数-PSQI:p<0.05),且比轻度OSA患者更易疲劳(p=0.003),在两个贝克量表中的得分均显著高于“对照组”(p<0.02)。与下午(第5次)相比,UARS患者在清晨(第1次)的失误更多,比轻度OSA患者更明显(p=0.02)。与“对照组”相比,轻度OSA患者在第2次的失误比第5次更多(p=0.04)。
与轻度OSA相比,UARS患者的睡眠质量更差,更易疲劳,清晨的持续注意力也更差。而轻度OSA患者的持续注意力比对照组更差。